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General NPI Number Information
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NPI Number | 1306564273
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Entity Type | Individual
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Provider Name | KELLY SCOCCIA APRN-FNP
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Gender | Female
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Dates
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Enumeration Date | 08/17/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 707 HILL COUNTRY DR STE 106
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City | KERRVILLE
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State | TX
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Zip | 78028-5910
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Country | US
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Telephone | 830-896-0404
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Fax | 830-896-4343
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Provider Business Mailing Address
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Address Line | PO BOX 294898
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City | KERRVILLE
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State | TX
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Zip | 78029-4898
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Country | US
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Telephone | 830-896-0404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 1090198
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1090198
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License Number State | TX
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